CMS Price Transparency Data
Neurobehavioral status check
Facility: Mercyone Waterloo Medical Center
Billing Code: 96116 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 96116
- Insurance Median: $87
- Cash Discount Price: $253
- vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Mercyone Waterloo Medical Center is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.39x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$253
Average discount available for prompt cash payment at this facility.
Insurance Median
$87
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$220.6
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $220.6 (100%)
Cash / Self-Pay: $253 (115%)
Insurance Median: $87 (39%)
Cash: $253 (115% of Medicare)
Ins. Median: $87 (39% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $220.6 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $46 - $266 | 21% |
| Aetna | $51 - $253 | 23% |
| Albany County Correctional Facility | $56 - $87 | 25% |
| Ambetter / Centene | $56 - $119 | 25% |
| Amish Mennonite | $56 - $87 | 25% |
| Ascension St. Vincent Public Safety Medical | $56 - $87 | 25% |
| Bcccp-Michigan | $56 - $87 | 25% |
| Bccp | $56 - $87 | 25% |
| Blue Cross Blue Shield | $56 - $151 | 25% |
| Bmc Healthnet | $56 - $87 | 25% |
| Breast Grant-Connecticut | $56 - $87 | 25% |
| Broward County Dept Of Health | $56 - $87 | 25% |
| California Health And Wellness | $56 - $87 | 25% |
| Can Community Health Inc | $56 - $87 | 25% |
| Cardinal Innovations Lme | $56 - $87 | 25% |
| Care Connections Of Northern Iowa | $56 - $87 | 25% |
| Care Oregon Ohp | $56 - $87 | 25% |
| Cencal Health Plan | $56 - $87 | 25% |
| Cenpatico | $56 - $87 | 25% |
| Chhuny | $56 - $87 | 25% |
| Childrens Comm Health Plan | $56 - $87 | 25% |
| Childrens Medical Services Title 19 | $56 - $87 | 25% |
| Cigna | $56 - $209 | 25% |
| City Of Philadelphia | $56 - $87 | 25% |
| Cmh Allegan County | $56 - $87 | 25% |
| Cmh Ausable Valley | $56 - $87 | 25% |
| Cmh Barry County | $56 - $87 | 25% |
| Cmh Bay-Arenac County | $56 - $87 | 25% |
| Cmh Berrien County | $56 - $87 | 25% |
| Cmh Cass County | $56 - $87 | 25% |
| Cmh Central Mi County | $56 - $87 | 25% |
| Cmh Clinton-Eaton-Ingham County | $56 - $87 | 25% |
| Cmh Detroit Wayne Integrated Health Network | $56 - $87 | 25% |
| Cmh Genesee County | $56 - $87 | 25% |
| Cmh Ionia County | $56 - $87 | 25% |
| Cmh Jackson County/Lifeways | $56 - $87 | 25% |
| Cmh Kalamazoo | $56 - $87 | 25% |
| Cmh Kent County | $56 - $87 | 25% |
| Cmh Lenawee County | $56 - $87 | 25% |
| Cmh Livingston County | $56 - $87 | 25% |
| Cmh Macomb | $56 - $87 | 25% |
| Cmh Misc | $56 - $87 | 25% |
| Cmh Monroe County | $56 - $87 | 25% |
| Cmh Montcalm County | $56 - $87 | 25% |
| Cmh Muskegon County | $56 - $87 | 25% |
| Cmh Newaygo County | $56 - $87 | 25% |
| Cmh North Country | $56 - $87 | 25% |
| Cmh Northern Lakes County | $56 - $87 | 25% |
| Cmh Oakland County | $56 - $87 | 25% |
| Cmh Ottawa County | $56 - $87 | 25% |
| Cmh Van Buren County | $56 - $87 | 25% |
| Cmh Washtenaw County | $56 - $87 | 25% |
| Cmh Wayne County/Carelink | $56 - $87 | 25% |
| Cmh Wayne Cty/Com Liv Svcs | $56 - $87 | 25% |
| Cmh West Mi County | $56 - $87 | 25% |
| Community Benefit Health | $56 - $87 | 25% |
| Community Care Behavorial Health | $56 - $87 | 25% |
| Community Care Partners | $56 - $87 | 25% |
| Community Health Choice | $56 - $87 | 25% |
| Connections Csp | $56 - $87 | 25% |
| County Coroner | $56 - $87 | 25% |
| County Funding Generic | $56 - $87 | 25% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $56 - $87 | 25% |
| Dean Wi Badgercare | $56 - $87 | 25% |
| Delaware County Department Of Health | $56 - $87 | 25% |
| Delaware First Health | $56 - $87 | 25% |
| Delta Dental Nj | $56 - $87 | 25% |
| Dph Tb Program | $56 - $87 | 25% |
| Dscc | $56 - $87 | 25% |
| Eastpointe Lme | $56 - $87 | 25% |
| Family Health Network | $56 - $87 | 25% |
| Freedom First Healthcare | $56 - $87 | 25% |
| Fresno County Ccs | $56 - $87 | 25% |
| Ghc Scw Wi Badgercare | $56 - $87 | 25% |
| Harbor Health | $56 - $87 | 25% |
| Health Safety Net | $56 - $87 | 25% |
| Healthy Blue Ne | $56 - $87 | 25% |
| Hennepin Health | $56 - $87 | 25% |
| Humana | $56 - $112 | 25% |
| Id County Ada | $56 - $87 | 25% |
| Id County Canyon | $56 - $87 | 25% |
| Id County Cat Fund | $56 - $87 | 25% |
| Id County Other | $56 - $87 | 25% |
| Id County Payette | $56 - $87 | 25% |
| Idaho Dept Health And Wellfare | $56 - $87 | 25% |
| Idaho Womens Health Check | $56 - $87 | 25% |
| Indiana Breast Cervical Cancer | $56 - $87 | 25% |
| Inland Empire Health Plan | $56 - $87 | 25% |
| Intercommunity Health Ohp | $56 - $87 | 25% |
| Jai Medical System | $56 - $87 | 25% |
| Kern Family Health Plan | $56 - $87 | 25% |
| Keystone First | $56 - $87 | 25% |
| Keystone First Chip | $56 - $87 | 25% |
| La Care Health Plan | $56 - $87 | 25% |
| Lakeland Care Inc | $56 - $87 | 25% |
| Managed Health Services - Indiana | $56 - $87 | 25% |
| Maryland Breast & Cervical Program | $56 - $87 | 25% |
| Maryland Healthy Smiles - Scion Dental | $56 - $87 | 25% |
| Maryland Physicians Care | $56 - $87 | 25% |
| Massachusetts Behavioral Health Partnership | $56 - $87 | 25% |
| Mdwise | $56 - $87 | 25% |
| Medi-Cal | $56 - $87 | 25% |
| Medi-Cal Healthnet | $56 - $87 | 25% |
| Medstar Dc Healthy Family | $56 - $87 | 25% |
| Medstar Md Health Choice | $56 - $87 | 25% |
| Mo Home State Health Plan | $56 - $87 | 25% |
| Molina Centennial Care | $56 - $87 | 25% |
| Nascentia Health Options | $56 - $87 | 25% |
| New York Cancer Services Program | $56 - $87 | 25% |
| Nextlevel Health | $56 - $87 | 25% |
| Oregon Screenwise | $56 - $87 | 25% |
| Pace Of Southwest Michigan | $56 - $87 | 25% |
| Paramount Advantage | $56 - $87 | 25% |
| Parkland Community Health Plan | $56 - $87 | 25% |
| Partners Behavioral Lme | $56 - $87 | 25% |
| Peach State Healthplan | $56 - $87 | 25% |
| Philadelphia County Funding | $56 - $87 | 25% |
| Presbyterian Centennial Care | $56 - $87 | 25% |
| Prestige Health Choice | $56 - $87 | 25% |
| Priority Partners | $56 - $87 | 25% |
| Robert F Sing Program | $56 - $87 | 25% |
| Rx 340B Pass Along | $56 - $87 | 25% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $56 - $87 | 25% |
| Rx Medi-Cal | $56 - $87 | 25% |
| Rx Meridian Rx | $56 - $87 | 25% |
| Ryan White Florida Mssrp | $56 - $87 | 25% |
| Sandhills Center Lme | $56 - $87 | 25% |
| Screening For Life | $56 - $87 | 25% |
| St Joseph County Hlth Dpt | $56 - $87 | 25% |
| Sunshine State Health Plan | $56 - $87 | 25% |
| Superior Health | $56 - $87 | 25% |
| Tenncare | $56 - $87 | 25% |
| Texas Children'S Health Plan | $56 - $87 | 25% |
| Trillium Community Ohp | $56 - $87 | 25% |
| Tufts Health Public Plans | $56 - $87 | 25% |
| UnitedHealthcare | $56 - $237 | 25% |
| Vaya Health Lme | $56 - $87 | 25% |
| Washtenaw Health Plan | $56 - $87 | 25% |
| Wellsense Health Plan | $56 - $87 | 25% |
| Wi Womens Wellness | $56 - $87 | 25% |
| Iowa Total Care | $57 - $89 | 26% |
| Wellpoint | $58 - $90 | 26% |
| American Health Plan | $61 - $72 | 28% |
| Wc Corvel | $67 | 30% |
| Align Senior Care | $69 | 31% |
| Ally Align Care Adv | $69 | 31% |
| American Health Advantage Of Idaho | $69 | 31% |
| Aurora Special Needs | $69 | 31% |
| Blue Care Network Advantage | $69 | 31% |
| Blue Shield - De (Highmark) Medciare Advantage | $69 | 31% |
| Care Dimensions | $69 | 31% |
| Care Improvement Plus | $69 | 31% |
| Care Resources Pace | $69 | 31% |
| Careplus Health Plans | $69 | 31% |
| Cca - Zing Health | $69 | 31% |
| Cca Senior Care Options | $69 | 31% |
| Central Valley Medical Services Corp Pace | $69 | 31% |
| Champion Health Plan Mcr Advantage | $69 | 31% |
| Clear Spring Health | $69 | 31% |
| Clover Health | $69 | 31% |
| Commonwealth Care Alliance | $69 | 31% |
| Community Pace At Home | $69 | 31% |
| Eddy Senior Care-Pace | $69 | 31% |
| Eddy Seniorcare Pace | $69 | 31% |
| Elementcare | $69 | 31% |
| Evercare | $69 | 31% |
| Everence | $69 | 31% |
| Gateway Health Plan | $69 | 31% |
| Genesys Pace Of Genesee County | $69 | 31% |
| Georgia Health Advantage | $69 | 31% |
| Gold Advantage | $69 | 31% |
| Gpa Croell Redi Mix | $69 | 31% |
| Health America Advantra | $69 | 31% |
| Highmark Health Options Dual Plan | $69 | 31% |
| Hope Select Pace | $69 | 31% |
| Horizon Nj Total Care | $69 | 31% |
| Hudson Headwaters Pace | $69 | 31% |
| Huron Valley Pace | $69 | 31% |
| Innovative Integrated Health Community Plans | $69 | 31% |
| Johns Hopkins Advantage Md | $69 | 31% |
| Lasso Healthcare Msa | $69 | 31% |
| Life St Marys Pace | $69 | 31% |
| Lifecircles Pace | $69 | 31% |
| Longevity Health Plan | $69 | 31% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $69 | 31% |
| Martins Point Generations Advantage | $69 | 31% |
| Mass General Brigham Mcr Adv | $69 | 31% |
| Medicare (plans) | $69 - $73 | 31% |
| Medipak Advantage | $69 | 31% |
| Mercy Life | $69 | 31% |
| Mercyone Cedar Valley | $69 | 31% |
| Meridian Complete | $69 | 31% |
| Michigan Complete Health | $69 | 31% |
| Nascentia Health Plus | $69 | 31% |
| New Centry Health Careplus | $69 | 31% |
| Osu Prime Care Advantage | $69 | 31% |
| Pace Cny | $69 | 31% |
| Pace Iowa Immanuel Pathways | $69 | 31% |
| Pace Southeast | $69 | 31% |
| Pace-Trinity Health | $69 | 31% |
| Peak Pace Solutions | $69 | 31% |
| Perennial Advantage | $69 | 31% |
| Preferred Care Partners | $69 | 31% |
| Presbyterian Senior Plan | $69 | 31% |
| Provider Partners Health Plan Of Illinois | $69 | 31% |
| Provider Partners Health Plan Of Indiana | $69 | 31% |
| Pruitthealth Premier | $69 | 31% |
| Reliance Community Care Partners Care Resources Pace | $69 | 31% |
| Rx Allwin | $69 | 31% |
| Rx Grane Grnmedd | $69 | 31% |
| Rx Retiree Rx Care | $69 | 31% |
| Scan Health Plan Mcr Ipa Meritage Oon | $69 | 31% |
| Secure Horizons Ma Pffs | $69 | 31% |
| Serenity Pace | $69 | 31% |
| Siouxland Pace | $69 | 31% |
| Solis Health Plans | $69 | 31% |
| Sunnyview-Pace Finance Dept | $69 | 31% |
| Texan Plus | $69 | 31% |
| The Health Plan | $69 | 31% |
| Thome Pace | $69 | 31% |
| Todays Options | $69 | 31% |
| Tribute Health Plans | $69 | 31% |
| Um Health Advantage | $69 | 31% |
| Union Health Service | $69 | 31% |
| Welbe Health | $69 | 31% |
| Wellmed | $69 | 31% |
| Veterans Administration | $70 | 32% |
| Iowa Health Advantage | $72 | 33% |
| Champva | $74 | 34% |
| Tricare | $74 | 34% |
| Triwest Health Alliance | $74 | 34% |
| Us Family Health Plan | $74 | 34% |
| Veterans Eval Services | $74 | 34% |
| Amps | $76 - $95 | 34% |
| Amish Hospital Aid | $93 | 42% |
| Stephenson Cty Health | $97 | 44% |
| Avera | $106 | 48% |
| Sanford Health Plan | $115 | 52% |
| Medical Associates | $117 | 53% |
| Nebraska Total Care | $118 | 53% |
| Ucare | $124 | 56% |
| Lucent Health | $126 | 57% |
| Bcn Domestic | $128 - $151 | 58% |
| Blue Benefit Administrators Of Massachusetts | $128 - $151 | 58% |
| Blue Care Network | $128 - $151 | 58% |
| Blue Distinction Transplant | $128 - $151 | 58% |
| Blue Shield - Ca | $128 - $151 | 58% |
| Blue Shield - Id (Regence) | $128 - $151 | 58% |
| Blue Shield - Ny Highmark Northeastern | $128 - $151 | 58% |
| Blue Shield - Ny Highmark Western | $128 - $151 | 58% |
| Blue Shield - Pa (Highmark) | $128 - $151 | 58% |
| Blue Shield - Wa (Regence) | $128 - $151 | 58% |
| Health Choices | $128 - $209 | 58% |
| Kaiser Domestic | $128 - $151 | 58% |
| Pre-Employment | $128 - $151 | 58% |
| Wc Domestic | $128 - $151 | 58% |
| Health Smart | $130 | 59% |
| Usa Managed Care | $136 | 62% |
| Centivo | $137 | 62% |
| Oscar | $137 | 62% |
| Health Partners | $143 - $175 | 65% |
| Claimdoc | $147 | 67% |
| The Alliance | $148 - $190 | 67% |
| Global Excel | $159 | 72% |
| Preferred One | $163 | 74% |
| Newton Correctional Facility | $164 - $174 | 74% |
| Velocity | $165 | 75% |
| Quiktrip | $176 | 80% |
| Genex Wc | $190 | 86% |
| Wc Align Network | $202 | 92% |
| Allied Benefit Systems | $209 | 95% |
| Auxiant | $209 | 95% |
| First Choice Health | $209 | 95% |
| Group Administrators | $209 | 95% |
| Midlands | $209 | 95% |
| Midlands Choice | $209 | 95% |
| Wc Praxis Health Network | $215 | 97% |
| Wc Reny Company | $220 | 100% |
| Wc Velocity | $220 | 100% |
| Meritain | $221 | 100% |
| Geha | $226 | 102% |
| Auto Velocity | $228 | 103% |
| Wc O'Hara Corp | $228 | 103% |
| Andrie Inc | $253 | 115% |
| East Greenbush Central School District | $253 | 115% |
| Healthsmart Workers Comp | $253 | 115% |
| Iowa Dept Of Public Health | $253 - $266 | 115% |
| Jag Source | $253 | 115% |
| Multiplan | $253 - $258 | 115% |
| New York State Insurance Fund | $253 | 115% |
| Njm Insurance Group | $253 | 115% |
| Rx Heatlhcomp | $253 | 115% |
| Rx Restat | $253 | 115% |
| Rx Saif Opdp Wc | $253 | 115% |
| Rx Worker'S Comp | $253 | 115% |
| Wc Accident Fund | $253 | 115% |
| Wc Ace | $253 | 115% |
| Wc Acs Federal Employees | $253 | 115% |
| Wc Acuity | $253 | 115% |
| Wc Advantage | $253 | 115% |
| Wc Aegis | $253 | 115% |
| Wc Aig | $253 | 115% |
| Wc Aims | $253 | 115% |
| Wc Alaska National Ins | $253 | 115% |
| Wc Allied | $253 | 115% |
| Wc Am Trust N America | $253 | 115% |
| Wc American Claims Mgmt | $253 | 115% |
| Wc Amerisure | $253 | 115% |
| Wc Amtrust | $253 | 115% |
| Wc Asu Risk Mgt | $253 | 115% |
| Wc Benetech | $253 | 115% |
| Wc Berkley Admin | $253 | 115% |
| Wc Broadspire | $253 | 115% |
| Wc Broward County | $253 | 115% |
| Wc Bunch & Associates | $253 | 115% |
| Wc California State Comp Ins | $253 | 115% |
| Wc California State Ins Fund | $253 | 115% |
| Wc Capitol Area Health Consortium | $253 | 115% |
| Wc Ccmsi | $253 | 115% |
| Wc Chartis | $253 | 115% |
| Wc Chubb | $253 | 115% |
| Wc Cirma | $253 | 115% |
| Wc City Of Albany | $253 | 115% |
| Wc City Of Sioux City | $253 | 115% |
| Wc Claims Mgmt Inc | $253 | 115% |
| Wc Cna | $253 | 115% |
| Wc Comp One Admin C/O Manageability | $253 | 115% |
| Wc Compone Admin | $253 | 115% |
| Wc Ct Healthcare Trust | $253 | 115% |
| Wc Donegal Insurance Group | $253 | 115% |
| Wc Emc Insurance Company | $253 | 115% |
| Wc Employee Mutual | $253 | 115% |
| Wc Enablecomp | $253 | 115% |
| Wc Encore Health Network | $253 | 115% |
| Wc Erie | $253 | 115% |
| Wc Esis | $253 | 115% |
| Wc Evolutions | $253 | 115% |
| Wc Fcci | $253 | 115% |
| Wc Fed Ex | $253 | 115% |
| Wc Federal Black Lung | $253 | 115% |
| Wc Federated | $253 | 115% |
| Wc Finley Occupational Health | $253 | 115% |
| Wc First Agency/Occunet | $253 | 115% |
| Wc Ford Motor | $253 | 115% |
| Wc Fresno Unified Emp | $253 | 115% |
| Wc Gallagher Bassett | $253 | 115% |
| Wc General Motors | $253 | 115% |
| Wc Generic | $253 | 115% |
| Wc Genex Care For Ohio | $253 | 115% |
| Wc Great West Casualty | $253 | 115% |
| Wc Guarantee Insurance | $253 | 115% |
| Wc Guard Insurance Company | $253 | 115% |
| Wc Hab | $253 | 115% |
| Wc Hartford | $253 | 115% |
| Wc Hastings | $253 | 115% |
| Wc Health Management | $253 | 115% |
| Wc Heritage Summit | $253 | 115% |
| Wc Hireright | $253 | 115% |
| Wc Horizon | $253 | 115% |
| Wc Icw Group | $253 | 115% |
| Wc Idaho State Ins Fund | $253 | 115% |
| Wc Intercare Insurance | $253 | 115% |
| Wc Intermountain | $253 | 115% |
| Wc Johns Eastern | $253 | 115% |
| Wc Kemberton | $253 | 115% |
| Wc Key Ins & Benefit Solutions | $253 | 115% |
| Wc Liberty Mutual | $253 | 115% |
| Wc Mac Risk Management | $253 | 115% |
| Wc Massachusetts | $253 | 115% |
| Wc Mdia | $253 | 115% |
| Wc Meadowbrook Claim | $253 | 115% |
| Wc Medical Administrators | $253 | 115% |
| Wc Meijers | $253 | 115% |
| Wc Memic | $253 | 115% |
| Wc Mercy Workcare | $253 | 115% |
| Wc Michigan | $253 | 115% |
| Wc Michigan Millers Mutual | $253 | 115% |
| Wc Mitchell Frankenmuth | $253 | 115% |
| Wc Mra | $253 | 115% |
| Wc Nationwide | $253 | 115% |
| Wc Nca Comp | $253 | 115% |
| Wc New York | $253 | 115% |
| Wc New York Special Funds | $253 | 115% |
| Wc North American Rishces | $253 | 115% |
| Wc Northeast Health | $253 | 115% |
| Wc Notre Dame | $253 | 115% |
| Wc Novanet | $253 | 115% |
| Wc Occ Health Allen | $253 | 115% |
| Wc Ohio Bureau | $253 | 115% |
| Wc One Call Medical | $253 | 115% |
| Wc Paradigm | $253 | 115% |
| Wc Peerless | $253 | 115% |
| Wc Pma | $253 | 115% |
| Wc Price Chopper | $253 | 115% |
| Wc Procura Management | $253 | 115% |
| Wc Qualcare | $253 | 115% |
| Wc Quiktrip | $253 | 115% |
| Wc Rev Claims | $253 | 115% |
| Wc Risico | $253 | 115% |
| Wc Rural Mutual | $253 | 115% |
| Wc Saif Oregon | $253 | 115% |
| Wc Secura | $253 | 115% |
| Wc Sedgwick | $253 | 115% |
| Wc Sentry | $253 | 115% |
| Wc Sheakley Unicomp | $253 | 115% |
| Wc Smile Lodge | $253 | 115% |
| Wc Society | $253 | 115% |
| Wc Srs | $253 | 115% |
| Wc Taconic (Mro) | $253 | 115% |
| Wc Taconic Farms | $253 | 115% |
| Wc Travelers | $253 | 115% |
| Wc Triad Group | $253 | 115% |
| Wc Tristar | $253 | 115% |
| Wc Troy Ny | $253 | 115% |
| Wc Tyson | $253 | 115% |
| Wc Unified Health Services | $253 | 115% |
| Wc United Heartland | $253 | 115% |
| Wc Us Dept Of Labor | $253 | 115% |
| Wc Walmart | $253 | 115% |
| Wc West Bend | $253 | 115% |
| Wc West Bend Mutual/Argent | $253 | 115% |
| Wc Winnebago Industries | $253 | 115% |
| Wc Yankee Trails | $253 | 115% |
| Wc York Risk | $253 | 115% |
| Wc Zenith | $253 | 115% |
| Wc Zurich | $253 | 115% |